Department of Pathology, Diabetes Research Center, Free University of Brussels, Belgium.
Islets. 2011 Jul-Aug;3(4):131-8. doi: 10.4161/isl.3.4.15728. Epub 2011 Jul 1.
The histopathology of type 1 diabetes is defined by a decreased β-cell mass in association with insulitis, a characteristic lymphocytic infiltration limited to the islets of Langerhans and prominent in early stage disease in children. A cytotoxic T-cell mediated destruction of insulin-producing β-cells is thought to be initiated by an unknown (auto)antigen, leading to the destruction > 75% of β-cell mass at clinical diagnosis. Although considered to be pathognomonic for recent onset disease, insulitis has only been described in approximately 150 cases over the past century. This review describes the quest for this elusive lesion and gives its incidence in various patient subpopulations stratified for age of onset and duration of the disease. It discusses recent new insights into the regenerative capacity of the β-cell mass in the pre-clinical stages of the disease and relates these findings to the inflammatory processes within the islet tissue.
1 型糖尿病的组织病理学特征为β细胞数量减少，伴有胰岛炎，这是一种特征性的淋巴细胞浸润，局限于胰岛，在儿童早期疾病中更为突出。一种由未知（自身）抗原引起的细胞毒性 T 细胞介导的胰岛素产生β细胞的破坏被认为是疾病的起始因素，导致在临床诊断时β细胞数量减少>75%。尽管胰岛炎被认为是近期发病的特征性病变，但在过去一个世纪中，仅在大约 150 例病例中描述过这种病变。本文综述了对这种难以捉摸的病变的探索，并描述了其在不同发病年龄和疾病持续时间的患者亚群中的发生率。本文还讨论了在疾病的临床前阶段β细胞数量再生能力的最新新见解，并将这些发现与胰岛组织内的炎症过程联系起来。
